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General NPI Number Information
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NPI Number | 1497301360
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Entity Type | Individual
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Provider Name | ELENA CHEPTENE
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Gender | Female
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Dates
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Enumeration Date | 08/15/2019
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 5000 STADIUM DR
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City | LOVES PARK
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State | IL
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Zip | 61111-2301
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Country | US
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Telephone | 779-513-8407
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Fax |
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Provider Business Mailing Address
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Address Line | 809A SPRING CREEK CT
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-7117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.301472
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License Number State | IL
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